butler's procedure overriding 5th toe - البروفيسور فريح عوده ابوحسان
DESCRIPTION
جراحة العظام / علاج العظام في الاردن / افضل دكتور عظام في الاردن / افضل اخصائي عظام في الاردن / استشاري عظام/ افضل استشاري عظام في الاردن / عمليات تطويل العظام في الاردن / اطباء العظام في الاردن / دكتور عظام في الاردن / الاطباء في الاردن / خلع ورك / عمليات اليزاروف في الاردن /علاج الكسور / خلع الولادة / تركيب المفاصل الاصطناعيه للركبه والورك / اوجاع العظام / افضل طبيب عظام اطفال في الاردن / استشاري اطفال عظام في الاردن / علاج خلع الكتف / علاج التواء الكاحل / التواء الكاحل / علاج الام العظام / علاج هشاشة العظام / ارقام اطباء عظام في الاردن / مشاكل العظام والمفاصل /مستشار جراحة العظام والمفاصل والكسور / مستشار جراحة عظام الأطفال.TRANSCRIPT
11/07/14Professor Freih Abuhassan - University of
Jordan 1
Freih Abu Hassan, F.R.C.S.(Tr & Orth.),Akram Shannak, F.R.C.S (Orth.) Mr. Frank McManus, F.R.C.S.I.
11/07/14 2Professor Freih Abuhassan - University of
Jordan
* Originally designed by Butler in Cambridge,
* Described by Cockin in 1968.
11/07/14 3Professor Freih Abuhassan - University of
Jordan
1- The toe is small, hyper extended, externally and medially rotated 2- Overlaps on the 4th toe.
3-The MTPJ is subluxed dorsomedialy.
11/07/14 4Professor Freih Abuhassan - University of
Jordan
4-The volar capsule adhered to the head of the metatarsal. 5-The extensor tendon is short, and displaced medially. 6-The 4th web space is contracted
11/07/14 5Professor Freih Abuhassan - University of
Jordan
A- Cosmetic concernB- Shoe wear problems C- Pain due to friction bursitis 50%D- Both
11/07/14 6Professor Freih Abuhassan - University of
Jordan
36 patients48 Butler’s procedure
PATIENTS
11/07/14 7Professor Freih Abuhassan - University of
Jordan
1980 - 2000
11/07/14 8Professor Freih Abuhassan - University of
Jordan
11/07/14 9Professor Freih Abuhassan - University of
Jordan
11/07/14 10Professor Freih Abuhassan - University of
Jordan
The assessments depends
1-overlapping.2- rotation3- scaring .4- range of movement of the 5th toe.
Each foot was given a grade excellent, good, or poor .
11/07/14 11Professor Freih Abuhassan - University of
Jordan
An excellent result1- absent overlap. 2-normal toe rotation, faint scar. 3- full range of movement.
Good results 1- mild overlap, mild rotation , slight scar.2- subnormal movement.
Poor results 1- severe overlap, severe rotation , contracture in the scar, or restricted movement
11/07/14 12Professor Freih Abuhassan - University of
Jordan
11/07/14 13Professor Freih Abuhassan - University of
Jordan
11/07/14 14Professor Freih Abuhassan - University of
Jordan
18 patients (22 feet, 59.46%)
graded good , their mean age 9.3 years.
11 patients (13 feet, 35.1%)
graded excellent ,their mean age 8.6 years.
1 patient with bilateral feet (5.4%)
graded poor due to recurrence.
11/07/14 15Professor Freih Abuhassan - University of
Jordan
7 patients (11 feet)
chart follow- up 1-2 Y.
satisfactory, straight toe, a symptomatic,
no deformity or scaring.
6 patients (10 feet)
graded good, their (mean age 8.53 years) one patient graded poor due to recurrence in the first 6 M P.Op.
11/07/14 16Professor Freih Abuhassan - University of
Jordan
0
2
4
6
8
10
12
14
16
Age
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22
Consecutive feet
Good group
Excellent group
Poor group
Age at operation of different groups.
11/07/14 17Professor Freih Abuhassan - University of
Jordan
0
2
4
6
8
10
12
14
16
Age
1 2 3 4 5 6 7 8 9 10
Feet
Chart follow up feet
Good group
Poor group
11/07/14 18Professor Freih Abuhassan - University of
Jordan
Excellent27%
Good67%
Poor6%
Excellent
Good
Poor
Outcome of all feet
11/07/14 19Professor Freih Abuhassan - University of
Jordan
1-A useful surgical technique 2-A significant high rate of success 3- Safe, very effective for all age group.4- No serious complications.
11/07/14 20Professor Freih Abuhassan - University of
Jordan
11/07/14Professor Freih Abuhassan - University of
Jordan 21